David C. Taylor, M. D. , Mark D. Kettler, M. D. , Gregory L. Moneta, M

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Presentation transcript:

Duplex ultrasound scanning in the diagnosis of renal artery stenosis: A prospective evaluation David C. Taylor, M.D., Mark D. Kettler, M.D., Gregory L. Moneta, M.D., Ted R. Kohler, M.D., Andris Kazmers, M.D., Kirk W. Beach, M.D., Ph.D, D.Eugene Strandness, M.D. Journal of Vascular Surgery Volume 7, Issue 2, Pages 363-369 (February 1988) DOI: 10.1016/0741-5214(88)90156-5 Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Renal duplex scan shows B-mode ultrasound image (transverse section) of the right renal artery and corresponding normal Doppler spectral analysis. RRA = right renal artery; Ao = aorta. Journal of Vascular Surgery 1988 7, 363-369DOI: (10.1016/0741-5214(88)90156-5) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Renal aortic ratio (RAR) plotted against angiographically determined degree of renal artery stenosis. The horizontal line represents a RAR of 3.5, which was used as the criteria for the diagnosis of 60% to 99% diameter-reducing stenosis. Journal of Vascular Surgery 1988 7, 363-369DOI: (10.1016/0741-5214(88)90156-5) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Renal duplex scan in a patient with 60% to 99% diameter-reducing stenosis of the left renal artery. Note the localized peak systolic velocity increase in the area of stenosis and the poststenotic turbulence associated with this. The ratio of the renal-to-aortic velocities in this patient was 9.4. Journal of Vascular Surgery 1988 7, 363-369DOI: (10.1016/0741-5214(88)90156-5) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Algorithm shows the proposed use of duplex scanning in the evaluation of hypertensive patients for the presence of renal artery stenosis. PTA = percutaneous transluminal angioplasty. Journal of Vascular Surgery 1988 7, 363-369DOI: (10.1016/0741-5214(88)90156-5) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Renal duplex scan of a patient with a renal transplant with 60% to 99% diameter-reducing stenosis of the renal artery at the level of the renal artery anastomosis. Note the localized velocity increase in the area of the stenosis. Journal of Vascular Surgery 1988 7, 363-369DOI: (10.1016/0741-5214(88)90156-5) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions